Soft tissues, such as ligaments, tendons and muscles, are attached to a large portion of the human skeleton. In particular, many ligaments and tendons are attached to the bones which form joints, such as shoulder and knee joints. A variety of injuries and conditions require attachment or reattachment of a soft tissue to bone. For example, when otherwise healthy tissue has been torn away from a bone, surgery is often required to reattach the tissue to the bone to allow healing and a natural reattachment to occur.
A variety of injuries and conditions require repair of soft tissue damage, or reattachment of soft tissue to bone and/or surrounding tissue. One example of otherwise healthy tissue being torn away from a bone is a shoulder rotator cuff tendon being partially or completely torn from a humerus (a rotator cuff tear). Surgery is often required to reattach the tissue to the bone to allow healing and reattachment to occur. A number of devices and methods have been developed for performing these surgical repairs, such as screws, pins, staples, cement, suture anchors, and sutures.
One method of repairing damaged soft tissue is to form a receiving hole into the bone, e.g., with an awl, tap, or drill, and then a bone anchor is inserted into the hole using an installation tool that is effective to lock the bone anchor within the bone hole. The free ends of the suture can then be passed through or around tissue and tied to secure the tissue to the bone. Alternatively, in some soft tissue reattachment procedures, the soft tissue can be moved into position over the bone, and a hole may be formed through the tissue and then an aligned hole formed through the bone. A bone anchor can then be passed through the tissue and deployed into the bone. The free end of the suture is then tied to secure the tissue to the bone. In either procedure, the knotting process can be difficult and tedious, particularly during laparoscopic or arthroscopic procedures, where the surgeon must remotely manipulate the suture using tools inserted through an access tube. Such procedures often require the use of multiple bone anchors and multiple sutures requiring multiple knots to securely attach the tissue to bone and prevent the risk of tearing. Additionally, passing one or more sutures through the tissue can require extensive, time-consuming manipulation of the tissue and suture(s).
Another method of repairing damaged soft tissue is to form multiple holes into bone, with the holes converging. One or more sutures passed through or around tissue can be passed through the multiple holes and tied to secure the tissue to the bone. However, it can be difficult to achieve the proper trajectories of the holes so they converge within the bone. It can also be difficult and cumbersome to form the holes, which to converge are typically formed through different sides of the bone. Accessing the different sides of the bone can require different positioning of the patient and/or the surgeon, which can be awkward and time consuming. Additionally, similar to that discussed above, knotting the sutures can be difficult and tedious, particularly during laparoscopic or arthroscopic procedures.
Accordingly, there remains a need for improved methods and devices for forming bone tunnels.